研究动态
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扎鲁替尼-来那度胺-利妥昔单抗 (ZR2) 治疗不适弥漫性大 B 细胞淋巴瘤:有效且耐受。

Zanubrutinib-lenalidomide-rituximab (ZR2) in unfit diffuse large B-cell lymphoma: efficient and tolerant.

发表日期:2023 Nov 14
作者: Yawen Wang, Jiadai Xu, Panpan Li, Yanyan Xu, Hongwei Xue, Peng Liu
来源: MOLECULAR & CELLULAR PROTEOMICS

摘要:

本研究的目的是检查 zanubrutinib、rituximab 和 lenalidomide (ZR2) 在不健康的弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者中的有效性和安全性。还评估了 ZR2 方案的血栓或出血风险,尤其是同时服用抗血小板药物时。我们回顾性审查了 2019 年 12 月至 2022 年 2 月期间在两个医疗中心接受 ZR2 方案治疗的不合格新诊断 (ND) 和难治性或复发 (R/R) DLBCL 患者。分析了生存率(OS)、出血不良事件(AE)和血栓形成事件。此外,我们还研究了 zanubrutinib 单独使用或与来那度胺联合使用对体外和体内血小板功能的影响。共有 30 名接受 ZR2 方案的不适合患者(13 名 ND DLBCL 和 17 名 R/R DLBCL 患者)参加了该研究(中位年龄:69.5 岁)。 ND DLBCL 和 R/R DLBCL 的最终 ORR 分别为 77.0% 和 50.1%。中位随访时间为 16.6 个月。随访期间未达到中位 PFS 和 OS。 4 例患者发生皮下出血 AE,3 例患者出现严重出血事件,2 例患者观察到血栓事件。 ZR2 方案在体外和体内功能测试中抑制血小板功能(聚集、凝块回缩、扩散和激活),尤其是对胶原蛋白的反应。 ZR2 对于不适合的 DLBCL 患者来说是一种有效的治疗选择,并且具有良好的耐受性。值得注意的是,该方案抑制血小板功能。对于接受该方案治疗的患者,应谨慎使用抗血小板药物。© 2023。作者获得 Springer-Verlag GmbH 德国(Springer Nature 旗下公司)的独家许可。
The objective of this study is to examine the effectiveness and safety of zanubrutinib, rituximab, and lenalidomide (ZR2) in unfit patients with diffuse large B-cell lymphoma (DLBCL). Thrombosis or bleeding risk of ZR2 regimen, especially when antiplatelet agents were co-prescribed, was also evaluated. We retrospectively reviewed unfit newly diagnosed (ND) and refractory or relapsed (R/R) patients with DLBCL who were administered with ZR2 regimen in two medical centers between December 2019 and February 2022. Response rates, progression-free survival (PFS), overall survival (OS), bleeding adverse events (AEs), and thrombosis episodes were analyzed. Furthermore, we investigated the effects of zanubrutinib alone or in combination with lenalidomide on platelet functions in vitro and in vivo. A total of 30 unfit patients (13 ND DLBCL and 17 R/R DLBCL patients) who received ZR2 regimen were enrolled in the study (median age: 69.5 years). The ultimate ORRs for the ND DLBCL and R/R DLBCL were 77.0% and 50.1%, respectively. The median follow-up was 16.6 months. The median PFS and OS were not achieved during the follow-up time. Subcutaneous hemorrhage AEs occurred in four cases, three cases suffered severe bleeding events, and thrombosis events were observed in two patients. ZR2 regimen inhibited platelet functions (aggregation, clot retraction, spreading and activation) in vitro and in vivo function testing especially in response to collagen. ZR2 is an efficient treatment option for unfit patients with DLBCL and could be well tolerated. Notably, this regimen inhibited platelet functions. Antiplatelet agents should be used with caution in patients treated with this regimen.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.